POS1559 THE CHARACTERISTICS OF THE PATIENTS UNDER NINTEDANIB TREATMENT DUE TO INTERSTITIAL LUNG DISEASES ASSOCIATED WITH CONNECTIVE TISSUE DISEASES
Authors: E. Tekgoz, S. Colak, E. Cimen Gunes, N. Ocal, D. Dogan, C. Tasci, M. Çinar, S. Yilmaz
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Nintedanib provides a decline in the reduction of forced vital capacity (FVC) in patients with progressing lung fibrosis. <h3>Objectives</h3> To assess demographical, clinical, and radiological characteristics of the patients with connective tissue diseases (CTDs) associated interstitial lung disease (ILD), who were under nintedanib treatment. <h3>Methods</h3> This retrospective observational study was conducted with the patients who received nintedanib for progressing lung fibrosis associated with CTDs. The patients who had followed up between January 2020 and December 2022 included in the study. The demographical, clinical, and radiological data were obtained from patients' files. <h3>Results</h3> Twenty-two (14.8%) patients (11 male/11 female) with CTD related ILD who had a mean age of 65.9 ±7.6 had received nintedanib. The median disease duration was 49.5 (35.8-101.8) months for CTD and 43 (26.3-95) months for ILD. Eighteen (81.8%) patients had a CTD diagnosis prior to an ILD diagnosis. The median duration for nintedanib treatment was 10.5 (7-14.8) months. Eight (36.4%) patients had Sjogren's syndrome, 7 (31.8%) patients had systemic sclerosis, 5 (22.7%) patients had rheumatoid arthritis, and 2 (9.1%) patients had undifferentiated CTD. Ten (45.5%) patients had a history of smoking. Only one patient was using nintedanib 150 mg/day due to gastrointestinal intolerance. Hypertension was the most frequent comorbidity in 5 (22.2%) patients, and the second most frequent one was pulmonary hypertension in 3 (13.6%) patients. During 6 minutes walking test, 12 (55.5%) patients had desaturation. According to high-resolution computed tomography (HRCT) findings, 18 (81.8%) patients had usual interstitial pneumonia (UIP) pattern, and 4 (18.2%) patients had nonspecific interstitial pneumonia (NSIP) pattern. The most frequent parenchymal pattern was UIP (p&lt;0.005). There was no mortality in the study group. Twelve (55.5%) patients had received at least one immunosuppressive treatment. Nintedanib was initiated due to the progression of fibrosis in HRCT in half of the patients or declined pulmonary function test results in the other half. All patients had worsening pulmonary symptoms. The mean FVC value of the patients at the beginning was 87±12.2 ml, and it was 89.3±14.8 ml at the 6th-month follow-up visit with no statistically significant difference (p=0.51). Four (66.7%) patients had stable findings, 2 (33.3%) patients had progression on HRCT, of whom had control HRCT under nintedanib treatment. Combined with nintedanib, cyclophosphamide (1 patient), rituximab (1 patients), azathioprine (3 patients), and mycophenolate mofetil (4 patients) were used. The most common side effect of nintedanib was diarrhea. <h3>Conclusion</h3> Nintedanib is a promising agent for progressive lung fibrosis in patients with CTD-related ILD. Since physicians can safely combine it with immunosuppressive agents, more patients will benefit in the course of time. Prospective studies with longer follow-up, and larger samples are necessary to examine the role of nintedanib on lung fibrosis. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.